922 resultados para medically fragile
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Mode of access: Internet.
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We sought to determine the relative impact of myocardial scar and viability on post-infarct left ventricular (LV) remodeling in medically-treated patients with LV dysfunction. Forty patients with chronic ischemic heart disease (age 64±9, EF 40±11%) underwent rest-redistribution Tl201 SPECT (scar = 50% transmural extent), A global index of scarring for each patient (CMR scar score) was calculated as the sum of transmural extent scores in all segts. LV end diastolic volumes (LVEDV) and LV end systolic volumes (LVESV) were measured by real-time threedimensional echo at baseline and median of 12 months follow-up. There was a significant positive correlation between change in LVEDV with number of scar segts by all three imaging techniques (LVEDV: SPECT scar, r = 0.62, p < 0.001; DbE scar, r = 0.57, p < 0.001; CMR scar, r = 0.52, p < 0.001) but change in LV volumes did not the correlate with number of viable segments. ROC curve analysis showed that remodeling (LVEDV> 15%) was predicted bySPECTscars(AUC= 0.79),DbEscars(AUC= 0.76),CMR scars (AUC= 0.70), and CMR scar score (AUC 0.72). There were no significant differences between any of the ROC curves (Z score
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Background. Food allergy is related to poorer quality of life (QoL) and mental health of caregivers. Many parents diagnose food allergy in their child without seeking medical care and there is limited research on this group. This study investigated parental QoL and mental health in parents of children with parent-diagnosed food allergy (PA), medically diagnosed food allergy (MA), and a control group with no allergy (NA). Methods. One hundred and fifty parents from a general population completed validated measures of QoL, anxiety, depression, and stress. Results. Parents of children with food allergy (PA or MA) reported higher stress, anxiety, and depression than the control group (all ). Parents of children with MA reported poorer food allergy related QoL compared to parents of children with PA (); parents of children with PA reported poorer general QoL compared to parents of children with MA (). Conclusion. Parents of children with food allergy have significantly poorer mental health compared to healthy controls, irrespective of whether food allergy is medically diagnosed or not. It is important to encourage parents to have their child medically tested for food allergy and to recognise and refer for psychological support where needed.
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Aims - Up to 10% of audiology patients report diffi culties hearing speech in noise even though clinical investigation reveals normal hearing thresholds, in other words, no evidence of physical pathology. The diagnostic category applied to these patients is known as King-Kopetzky Syndrome (KKS). This study aimed to gather descriptions of patients' experiences of the clinical encounter involving their KKS diagnosis and analyse the themes of help-seeking, as part of a larger study into the process of coping with medically unexplained hearing diffi culties. Method - A qualitative approach was employed, comprising unstructured interviews in the homes of 25 patients who had attended audiology services (and received a diagnosis of KKS) in Bath and Cardiff. Thematic analysis of transcripts was undertaken, infl uenced by grounded theory techniques. Findings - Informants characterized the clinical encounter as either negative or positive. Negative consultations were those in which patients' illness claims were dismissed and as such not validated. Positive encounters were typifi ed by the provision of meaningful information that reconciled clinical information with the patients' experiences of hearing loss. Conclusion - Successful management of medically unexplained illnesses requires the adoption of a patient-centred approach, rather than focusing on the absence of observable pathology
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This paper provides the historic background of the Florida International University College of Medicine planning process.
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Acknowledgements This study was funded by the Chief Scientist Office of the Scottish Government, grant CZH_4_495.
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An IAPT service and a clinical health psychology team piloted a service development providing Step 2 and Step 3 services for individuals with long-term health conditions. Results indicate that such services may be offered with access to specialist training and supervision.
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The secretaries of the secret were an essential element of the Holy Office’s district courts. They were in charge of record-ing and writing all of the official documents of these tribunals, but also of keeping the archive in order. And not only of these, so they were not the simple bureaucrats that the traditional historians wrote about. In fact, their long working hours turned a unique and much defined office into a complex taxonomy of professionals who shared the secretaries of the secret’s concerns but not their privileges. This paper aims to go in depth into these profession-als’ current life. They were not officials, but they take care of some important duties even if they were not getting paid for it.
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Introduction - This study was designed to determine the presence and identity of potential intermediate snail hosts of schistosomiasis in Bengo, Luanda, Kwanza Norte and Malanje Provinces in NW Angola. This is an area where infection with Schistosoma haematobium, causing urogenital schistosomiasis, is common but little is known about transmission of the disease. Angola has had a varied past with regards to disease control and is revitalising efforts to combat Neglected Tropical Diseases.